LESSONS LEARNED FROM AVIATION TO INFORM ACCESSIBILITY IN SPACE EXPLORATION.

BACKGROUND: One in 5 people worldwide lives with a disability, frequently facing challenges in aviation. This makes accessible space flight seem like a distant dream. Recently, ESA selected the first astronaut with a physical disability. Our ESA Topical Team supports this opportunity by reviewing the existing literature and lived experience in the field, to investigate the physical and physiological challenges and also the potential advantages of astronauts with disabilities. OVERVIEW: Given the overlap between the medical standards required for pilot medical certification and those for astronaut selection, we started by examining the experience of a disabled flying charity, Aerobility. Three key lessons were learned from this review which will support the collaboration between stakeholders when working with astronauts with physical impairments.The first lesson was to recognise that not everyone will meet the standards for aeromedical certification. Astronauts face similar requirements and a transparent approach to assessment is required. However, these criteria can evolve over time, as advancements in both medical and technological fields may mitigate the impact of physical impairments on an individual's ability to participate in space missions. The second lesson was that people with disabilities can meet the requirements for flying with adapted training and technical modifications. In this context, flexibility and open discussions are needed to understand individual needs and find optimal solutions. Likewise, considering astronauts, dedicated efforts are required to adapt systems and procedures, ensuring accessibility. The third lesson highlighted the significance of involving different stakeholders when reviewing recruitment, training, adaptations, and operations. Unconscious bias remains a challenge in the field. Without scientific evidence demonstrating the suitability of candidates with physical disabilities, space accessibility would remain partial. DISCUSSION: We reviewed the experience of a leading flying charity to define key lessons from aviation that could be translated and adapted for space flight. Our overarching goal is to evaluate the physiological considerations for people with physical disabilities in order to support ESA's team and space missions. This work will become even more relevant with the emergence of space tourism, and the need for accommodating a diverse array of candidates for both short-term and extended space flights. Learning Objectives 1. To discuss the requirements and adjustments for people with disabilities in aviation and how they can inform space missions. 2. To identify the needs and adjustments for astronauts with a physical disability. [ABSTRACT FROM AUTHOR]